Are We Cursed with Obesity from Birth?

McKinsey Global Institute issued a discussion paper titled “Overcoming obesity: An initial economic analysis,” some of whose details Childhood Obesity News has already recounted. It identifies obesity as a critical global issue, because almost 30% of the people currently inhabiting the planet are overweight or obese.

It goes on to mention that obesity is the basic cause behind about 5% of the world’s deaths every year. The McKinsey interpretation of the state of obesity management is intriguing because the institute’s analysts place a great deal of emphasis on the newly-emerging field of microbial medicine. As an essay titled “Closing in on microbiome therapy” told readers of The Economist:

There is growing evidence to suggest that autism spectrum and eating disorders, cardiovascular disease and metabolic conditions such as obesity and type 2 diabetes may all be associated with microbial imbalances in the gut…

The composition of any individual’s gut microbiome is initially dependent on the circumstances of birth. Dr. Noel T. Mueller calls the gastrointestinal tract “one of the most complex microbial systems on earth.” Depending on the health of the microbiome, a baby can face physiological doom from the moment of delivery. All locations are not equal, and neither are all gene pools. Geography and ethnic heritage count for a lot.

In our current state of knowledge, it looks like the activities of the microbiota are quite capable of producing chronic, low-level inflammation throughout the system. The theory is that such ongoing malaise can in turn initiate or exacerbate many different conditions from which the host humans may suffer or even die. All the intricate mechanisms have not been traced, but the overall picture seems to indicate that this is the case. Conversely, Dr. Mueller says:

Greater bacterial diversity of the gut is associated with protection from various diseases, including those that are autoimmune in nature, like asthma, and those that are metabolic in nature, like obesity.

How does a baby acquire such a desirably diverse assortment of bacteria? From its mother, of course. Dr. Mueller and his colleagues believe that delivery by Cesarean section can be detrimental, because the child is deprived of the journey through the birth canal, where normally it would be baptized by all kinds of microbial life. Breastfeeding is encouraged, because mother’s milk contains prebiotics that nourish the microbiome.

It also appears that the decision about when to introduce solid food can be crucial, and this research team encourages the launch of meticulous studies to figure it out. Antibiotics are another hazard, and one to be avoided by a pregnant woman if possible, because the microbiome of the fetus will be affected. Post-partum, antibiotics can save a baby’s life, but can also set the child up for digestive chaos by devastating the inner microbial population.

The Scientist reported on research which seems to indicate that the role of breastfeeding is immensely more complicated than anyone has previously suspected. It also appears that even more important than the mother’s vaginal microbiome is the microbiome of the placenta. In this barely explored field of inquiry, every discovery generates several new questions. Notes evolutionary geneticist Dr. Seth Bordenstein of Vanderbilt University:

Based on the sum of evidence, it is time to overturn the sterile womb paradigm and recognize the unborn child is first colonized in the womb.

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade. You can contact Dr. Pretlow at:

Presentations

Dr. Pretlow's 2017 Workshop on Treatment of Obesity Using the Addiction Model